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J Gynecol Obstet Biol Reprod (Paris) · Oct 2015
Review[Use of pessaries to prevent preterm birth: Are we going back to mechanical devices in obstetrics?].
- A-C Denormandie and J Nizard.
- Service de gynécologie obstétrique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 83, boulevard de l'Hôpital, 75013 Paris, France.
- J Gynecol Obstet Biol Reprod (Paris). 2015 Oct 1; 44 (8): 776-80.
AimTo review the available data in the literature on the use of pessaries in preventing preterm birth.Materials And MethodsWe searched PubMed and the Cochrane library with pessary preterm birth.ResultsFifty-eight papers were identified, most of them with little scientific value. A randomized study, including 385 singleton pregnancies with a transvaginal ultrasound cervical length less than 25 mm between 18 and 22 WG, shows a reduction of spontaneous prematurity before 34 WG in the pessary group, with an OR of 0.18 (95%CI: 0.08-0.37). Another study on multiple pregnancies randomized between 12 and 20 WG, with a cervix measured by ultrasound between 16 and 22 WG, showed a reduction of neonatal morbidity in the pessary group (RR: 0.42; 95%CI: 0.19-0.91) in a sub-group with a cervical length<38 mm.ConclusionsThese first results from randomized controlled study are encouraging. Other studies on singleton and twin pregnancies are ongoing or about to start.Copyright © 2015 Elsevier Masson SAS. All rights reserved.
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